a thickened intima ITSELF does NOT contain lipid droplets - it thickens due to SM muscle cell proliferation

Arteriosclerosis

a general term describing any hardening, loss of elasticity, & thickening of medium or large arteries

3 types:

1. Atherosclerosis (ATH)

2. Mönckeberg's Arteriosclerosis

3. Arteriolosclerosis

Atherosclerosis (ATH)

a specific form of arteriosclerosis in which hardening of the arteries is characterized by irregularly distributed lipid deposits in the tunica intima of large & medium-sized arteries

this causes a narrowing of arterial lumens which results in less blood being able to travel through increasing BP

proceeds eventually to fibrosis & calcification

causes more morbidity and mortality (~half of all deaths) in the Western world than any other disorder

otherwise known as Arteriosclerotic Vascular Disease (ASVD)

Mönckeberg's Arteriosclerosis (Medial Calcific Sclerosis)

arterial sclerosis involving the peripheral (muscular) arteries, especially of the legs of older people, w/ deposit of calcium in the tunica media (pipe-stem arteries) but with little or no encroachment on the lumen

protein made by the liver found in high levels in the blood in response to inflammation (is an acute-phase protein), specifically in response to factors released by macrophages & adipocytes

purpose is to bind to phosphocholine expressed on the surface of dead or dying cells there to activate the complement system

high levels of CRP can be more diagnostic for ATH than cholesterol levels

What is the response-to-Injury hypothesis of atherosclerosis pathogenesis?

the idea that atherosclerosis can be viewed as a chronic inflammatory response of the arterial wall to endothelial injury - it's possible that such a condition won't occur unless endothelial injury occurs first

the plaque is neovascularized & dystrophic calcification of cells can be seen

Plaque Neovascularization

growth of atherosclerotic plaques is accompanied by neovascularization from vasa vasorum microvessels extending through the tunica media into the base of the plaque and by lumen-derived microvessels through the fibrous cap

Cholesterol Clefts

the microscopic manifestation of extracellular accumulations of cholesterol in an atherosclerotic plaque

if released can travels w/ the bloodstream to other places in the body where it may obstructs blood vessels (embolism)

true aneurysms is a localized, blood-filled balloon-like bulge in the wall of a blood vessel that involves all 3 layers of the artery or the attenuated wall of the heart (eg. atherosclerotic & congenital vascular aneurysms, ventricular aneurysms resulting from transmural MI)

complications arise from rupture, thrombosis, or embolization

False Aneurysm (Pseudoaneurysm)

a hematoma that forms as the result of a leaking hole in an artery

the hematoma forms outside the arterial wall, so it is contained by the surrounding tissues

the extravascular hematoma communicates with the intravascular space (“pulsating hematoma”)

eg. ventricular ruptures contained by pericardial adhesions or leaks at the junction of a vascular graft w/ a natural artery

Dissection

a tear within the wall of a blood vessel that allows blood to separate the wall layers